40% of malaria patients are prone to acute kidney injury (AKl) : Dr Purohit

Prayagraj/New Delhi: According to the latest World Health Organization’s (WHO) World Malaria Report, on average 247 million cases of malaria are reported every year. While most cases show mild symptoms, a minority of cases could be fatal.
40% of malaria patients are prone to acute kidney injury (AKl) as per recent report of the Delhi based National Institute for Malaria Research said Dr Naresh Purohit, Advisor-National Vector Borne Disease Control Programme.

Addressing a regional seminar on “Accelerating the fight against malaria for a more equitable world ” organised by the Prayagraj based Motilal Nehru Medical College, renowned infectious disease expert Dr Purohit averred that malaria, a disease spread by mosquitoes, is caused by a parasite called Plasmodium. Typical symptoms of malaria include high-grade fever and chills.
“It is one of the most common infectious diseases globally and inflicts a huge burden on the public health systems in many developing countries.”he added

“In severe malarial disease, multi-organ dysfunction affecting organs such as the lungs, kidneys, and brain is common.”he said.

“In children, the incidence of AKI is reported at approximately 10%. AKI caused due to malaria can lead to immune dysregulation and inflammation and can contribute to physical and mental ailments. ” he pointed

“Severe malaria causes damage to fine urinary tubes within the kidney, a condition called acute tubular necrosis. AKI is defined by increased creatinine by more than 0.3 mg/dl within 48 hours or a reduction in urine volume to less than 0.5ml/kg/hour for 6 hours.” acclaimed medic revealed.  He stated that in most cases, AKI due to malaria is reversible if treated early. At the onset, mild laboratory abnormalities such as reduced haemoglobin, higher white cell count, low platelets, elevated ESR, liver enzyme abnormalities, and electrolyte (salts) disturbances may occur. With worsening disease severe symptoms related to anemia, liver disease and acute kidney injury may manifest. Reduced kidney function may result in the buildup of fluids, waste products or disturbances in salts like sodium and potassium. Splenic rupture is a much more serious problem occurring in a minority of individuals with AKI and severe malaria.

“Symptoms, as well as the severity of the disease,can vary from individual to individual. Seeking professional medical help at the earliest and appropriate investigations can lead to a rapid diagnosis. Initiating therapy at the outset can contain the disease and prevent progression to a severe disease state. “he added

He emphasised that kidney disease remains a huge burden on society, and it is estimated that about 10% of the adult population has some form of kidney disease. Approximately 220,000 people have severe kidney disease (end-stage kidney disease) needing dialysis every year and the lack of access and affordability to renal replacement therapy in the form of dialysis or transplantation to the majority is unfortunate.

He averred that given the significant morbidity associated with AKI secondary to malaria, it is imperative to have access to expert nephrologists,as such situations need close monitoring and treatment. There is a possibility of patients with severe AKI needing temporary dialysis therapy to deal with fluid overload and salt disturbances. Emphasis on bridging the significant health literacy gap is needed to effectively tackle the complications related to malaria, especially AKI. As we move into a fast-paced world it is important to prioritize one’s health by having regular check-ups to detect clinical irregularities (if any) and take precautions accordingly. These tests also draw attention to any abnormalities that might lead to chronic illnesses.

*Dr. Naresh Purohit-MD, DNB, DIH, MHA, MRCP(UK), is an Epidemiologist, Advisor-National Communicable Disease Control Program of Govt. of India, Madhya Pradesh and several state organizations.)

Dr.  Purohit is also Principal Investigator for the Association of Studies For Kidney Care.